Emily and her Father
During my recent visit to St. Mary’s Hospital Lacor in Gulu, Uganda, I had the opportunity to meet many of the children and adolescents on what is called the “Burkitt’s Ward”. One of the adolescents who I met was a 17 year old girl named Emily. Unlike many of the other patients and parents on the ward, Emily and her father were able to speak English. They both talked to me about Emily’s history and treatment for Burkitt lymphoma (BL).
In the late spring of 2016, Emily developed abdominal pain and swelling. Her parents, both teachers, took her to the local hospital nearby her home in the Arua District of Northern Uganda. She was thought to have had an ovarian cyst which was excised in July of 2016. Upon further examination of the cyst by pathologists, it was determined that she had BL. Ovarian tumors are common presentation features of BL in girls – Emily was 16 years old at the time of her initial diagnosis. The doctors at the local hospital referred her to Kuluva Hospital which is located in a suburb of Arua. The doctors at Kuluva Hospital are familiar with the treatment of BL and after further tests were performed, she began treatment according to a regimen similar to what is used at St. Mary’s Hospital Lacor for newly diagnosed patients with BL. She completed six cycles of therapy in November of 2016 and was then discharged home. She was able to return to school, but soon afterwards developed abdominal pain and swelling. The doctors at Kuluva Hospital referred Emily to St. Mary’s Hospital for treatment of suspected recurrent BL.
Once Emily arrived at Lacor Hospital, she underwent more tests, including a biopsy of one of the abdominal masses detected by scans. The diagnosis was again BL. Because she recurred so early after the completion of initial treatment, the decision was made to give her what is called Second Line therapy. Second Line therapy consists of different drugs that are considered effective against BL, but it is a more intensive treatment regimen that requires more complex care than what could be provided at Kuluva Hospital. As there has been success with Second Line therapy in many patients who have had resistant disease, this was considered the best treatment option for Emily.
Coming to Lacor Hospital has been difficult for Emily because it is over 250 kilometers away from her home. It takes nearly 6 hours by bus to come to Lacor. Her father reports that the costs of travel are becoming difficult for her family to afford because it costs approximately $20 for a round trip bus ticket for both Emily and her father. While this cost might not seem so high to donors to this project, travel costs such as these impose a substantial financial burden on poor families in Uganda who live on less than 2 dollars a day. When families such as Emily’s have more than one child, it can be extremely difficult to ensure that the other children are provided for when the one child with cancer is away from home.
Emily has nearly completed treatment and signs are optimistic that her BL has responded well to the new treatment. She and her father understand that it is important for her to complete all four cycles of treatment in order for her to have the best chance of a long-lasting cure. She loves school and misses going to classes and her friends, too. When I asked her what she wanted to do when she finished school, she said that she wanted to become a nurse. This is because of the example that has been set by the many nurses who have cared for her throughout this difficult time in her life. She just wants to be able to help sick children like the many she befriends on the ward.
Without your donations, St Mary’s Hospital Lacor would not have been able to offer Emily treatment for her relapse. And, thanks to your donations, Emily has a chance to fulfill her dream of becoming a nurse.